While the hospital's aim has remained the same throughout its history – to offer high quality medical care and present the Gospel to a marginalised, poor and neglected community – much has changed since the early years.
At the beginning, travel and supply from Bangkok to the hospital commonly took one day by train and two days by hang yaw boat, staff had to produce most of their own vegetables and meat, patients arrived at the hospital carried in seats suspended from bamboo poles, in ox-carts, in dugout canoes and on elephants, the mobile clinic was an ox cart and pair of bulls, and emergency communications with the outside world relied on border police telegrams.
Today, the hospital is a six hour journey from Bangkok on a surfaced road, there is a local weekly market and a number of shops, patients commonly arrive by motorcycle and some by pick-up truck, and the area has cell phone coverage.
The hospital came into being through the opening of the Sangklaburi Christian Mission Station in 1960, and the arrival of Dr Douglas O Copron, a UCMS (Disciples of Christ) missionary and the first hospital director. Medical work began immediately in a small wooden shed built to serve as a clinic until a hospital building was completed 3 years later.
In 1969 the name of the Sangkla Christian Mission was changed to the Kwai River Christian Mission to reflect the fact that the work was no longer only in the Sangkla District.
In July 1970, faced with a shortage of medical personnel, the hospital was required by law to temporarily cease operations. There was a brief re-opening during 1972, but it was not until March 1974, when Dr. John Freeman arrived, that the hospital fully reopened again. During the late 1970s the hospital commenced off-site public health clinics, seeing the potential for a village health program to prevent many more illnesses and deaths than a small hospital would otherwise be able to.
In 1984, the Hospital was relocated from Nitae village to Huay Malai village by Dr Phil McDaniel because of the construction of Vachiralongkorn dam. The main road to the area was paved in 1986. During the late 1980s off-site work was expanded to include water and sanitation projects, through which KRCH facilitated the installation of six gravity-fed village water systems.hospital was required by law to temporarily cease operations.
In February 2010, KRCH celebrated its 50th anniversary of ministry to the least. The anniversary began with a worship service at Sangkla Christian Church attended by representatives of the Church of Christ in Thailand, members of the hospital board, former directors of the hospital, hospital staff and former patients, and an evening celebration included a banquet on the front lawn of the hospital with Thai classical dancers and Mon folk dances in tribal costumes.
The following doctors have been directors of the hospital over the course of its history:
- Dr. Douglas O Copron (1960-1967)
- Dr. Roy A Myers (1967-1970)
- Dr. John D Freeman (1974-1977)
- Dr. Keith D Dahlberg (1977-?)
- Dr. Philip L McDaniel (1979-2002)
- Dr. Anchalee Tantawiwat (2002-2004)
- Dr. Sakda Netek (2004-2010)
- Dr. Scott Murray (2010 to present)